AUGUSTA, Maine (NEWS CENTER) -- People taking prescription opioids to manage pain gathered inside a hearing room at the statehouse Thursday to tell lawmakers the current law that sets limits on daily doses isn't working.
"And theres so much confusion within the medical community and I think there's collateral damage all over the place and this needs...if we're going to do this bill let's do it the right way," explained Brian Rocket a lobster wholesaler from Rockland who is taking opioids to deal with chronic pain.
Rocket says his doctor told him he had to taper down his daily dose of painkillers to comply with the law which sets dosage limits at 100 morphine milligram equivalents daily. Rocket, who was at about 4 times that amount, hired a lawyer to challenge the state law and he went to Augusta to testify in favor of a bill sponsored by Senator Geoff Gratwick that would make some changes to existing law.
"As a doctor I'm going to tell you listen it's very much better for you in the long run if you can get off your pain medications they're just not good for human beings. on the other hand some people need them and this bill allows the doctor, me and you to make that decision," Gratwick said.
Gratwick, who is also a physician who specializes in rheumatology, proposed a bill he says would give doctors the flexibility to exempt patients from the 100 MME limit as long as they exhausted every option for alternative treatment including:
Nonsteroidal anti-inflammatory drugs; Adjunctive medicines, including antidepressants; Physical therapy, occupational therapy or exercise; cognitive behavioral therapy; counseling and treatment regarding lifestyle changes including smoking cessation and diet. They must also confirm that a taper trial resulted in significant loss of function. There are also a number of documentation requirements for physicians.
Eric Wass, a roofing contractor who says he too is being forced to taper down his opioid prescription also thinks the bill is a good idea.
"My pain is getting worse because i have less medication to take at a time my company is getting busier and I'm in a catch 22 here," said Wass.
But Dr. Chris Pezzullo, who is the State Health Officer testified against the bill for DHHS. Pezzullo says the existing law already has exemptions in place.
"Essentially it's duplicative," said Pezzullo. "There's already a palliative care exemption in the law that allows for prescribers to use their own medical judgement to see if someone should be above the 100 morphine milligram equivalent."
The palliative care exemption in existing law, however, has been the cause of some confusion because the states legal definition of palliative care is different than an interpretation of palliative care held by members of the medical community. State law defines Palliative care as: patient-centered and family-focused medical care that optimizes quality of life by anticipating, preventing and treating suffering caused by a medical illness or a physical injury or condition that substantially affects a patient's quality of life.
Dr. Gratwick told lawmakers on the Health and Human Services Committee that many medical professionals interpret palliative care the way the World Health Organization does:
Palliative care is an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with life-threatening illness
Representative Patricia Hymanson, the committee chair, who is also a physician, did point out to Senator Gratwick that the only definition that should matter to physicians is the legal definition in state statute.
The states other problem with the bill is it creates several additional steps for physicians to take, which could be unnecessarily cumbersome. The bill is scheduled for a work session on April 26th.
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